title: Inverse association between circulating vitamin D and mortality--dependent on sex and cause of death?
abstract: OBJECTIVE
  In various populations, vitamin D deficiency is associated with chronic diseases and mortality. We examined the association between concentration of circulating 25-hydroxyvitamin D [25(OH)D], a marker of vitamin D status, and all-cause as well as cause-specific mortality.
  
  
  RESULTS
  The study included 3404 participants of the general adult Swiss population, who were recruited between November 1988 and June 1989 and followed-up until the end of 2008. Circulating 25(OH)D was measured by protein-bound assay. Cox proportional hazards regression was used to examine the association between 25(OH)D concentration and all-cause and cause-specific mortality adjusting for sex, age, season, diet, nationality, blood pressure, and smoking status. Per 10 ng/mL increase in 25(OH)D concentration, all-cause mortality decreased by 20% (HR = 0.83; 95% CI 0.74-0.92). 25(OH)D concentration was inversely associated with cardiovascular mortality in women (HR = 0.68, 95% CI 0.46-1.00 per 10 ng/mL increase), but not in men (HR = 0.97; 95% CI 0.77-1.23). In contrast, 25(OH)D concentration was inversely associated with cancer mortality in men (HR = 0.72, 95% CI 0.57-0.91 per 10 ng/mL increase), but not in women (HR = 1.14, 95% CI 0.93-1.39). Multivariate adjustment only slightly modified the 25(OH)D-mortality association.
  
  
  CONCLUSIONS
  25(OH)D was similarly inversely related to all-cause mortality in men and women. However, we observed opposite effects in women and men with respect to cardiovascular and cancer mortality.
authors.affiliation: Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland; Unit of Demography and Health Statistics, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland. Electronic address: sabine.rohrmann@ifspm.uzh.ch.
authors.forename: S
authors.initials: S
authors.lastname: Rohrmann
authors.forename: J
authors.initials: J
authors.lastname: Braun
authors.forename: M
authors.initials: M
authors.lastname: Bopp
authors.forename: D
authors.initials: D
authors.lastname: Faeh
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood*; D000328:Adult; D000368:Aged; D000375:Aging; D002112:Calcifediol / Q000097:blood*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D012727:Sex Characteristics; D013557:Switzerland / Q000453:epidemiology; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol
keywords: MONICA; Mortality; Switzerland; Vitamin D